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W2149726064 abstract "TrombĂłza stentu (stent thrombosis - ST) je sice vzĂĄcnou, ale potenciĂĄlnÄ Ĺživot ohroĹžujĂcĂ pĹĂhodou, s nĂĹž se lze setkat po perkutĂĄnnĂ koronĂĄrnĂ intervenci (percutaneous coronary intervention - PCI) s implantacĂ stentu. Ke vzniku trombu a rozvoji ST mĹŻĹže pĹispĂvat nÄkolik faktorĹŻ souvisejĂcĂch se samotnĂ˝m vĂ˝konem nebo charakteristikami pacienta. ZĂĄkladem strategie ke snĂĹženĂ vĂ˝skytu ST je duĂĄlnĂ protidestiÄkovĂĄ lĂŠÄba (dual antiplatelet therapy - DAPT) s kyselinou acetylsalicylovou a inhibitory P2Y12. Byly zjiĹĄtÄny dvÄ hlavnĂ pĹĂÄiny neĂşspÄĹĄnĂŠ DAPT: nevhodnÄ pĹedÄasnÄ ukonÄenĂĄ protidestiÄkovĂĄ lĂŠÄba a snĂĹženĂĄ odpovÄÄ na antiagregancia. PĹibĂ˝vĂĄ dĹŻkazĹŻ o tom, Ĺže reziduĂĄlnĂ vysokĂĄ reaktivita bÄhem lĂŠÄby (high platelet reactivity - HPR) je spojena se zvĂ˝ĹĄenĂ˝m rizikem trombotickĂ˝ch komplikacĂ vÄetnÄ ST po PCI. V poslednĂch letech byla vyvinuta Ĺada testĹŻ na stanovenĂ funkce krevnĂch destiÄek; nÄkterĂŠ z tÄchto testĹŻ se ve velkĂŠ mĂĹe pouĹžĂvajĂ v klinickĂ˝ch studiĂch pĹi stanovenĂ reziduĂĄlnĂ reaktivity destiÄek po podĂĄnĂ antiagreganciĂ. Pro optimalizaci protidestiÄkovĂŠ lĂŠÄby je naprosto nezbytnĂŠ vyhledĂĄvĂĄnĂ pacientĹŻ s HPR. PrvnĂ studie nicmĂŠnÄ naznaÄily, Ĺže dosaĹženĂ intenzivnÄjĹĄĂ inhibice krevnĂch destiÄek po pĹevedenĂ pacienta ze standardnĂho na intenzivnĂ lĂŠÄebnĂ˝ reĹžim podle reaktivity destiÄek nezajistilo ĹžĂĄdnĂ˝ pĹĂnos ve smyslu incidence pĹĂhod. NenĂ pochyb o tom, Ĺže individualizovanĂĄ farmakoterapie u pacientĹŻ absolvujĂcĂch PCI zĹŻstĂĄvĂĄ i nadĂĄle jednĂm z hlavnĂch cĂlĹŻ v ĂşsilĂ o pĹedchĂĄzenĂ vzniku zĂĄvaĹžnĂ˝ch komplikacĂ - vÄetnÄ ST - v souvislosti s PCI." @default.
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W2149726064 date "2013-04-01" @default.
W2149726064 modified "2023-09-29" @default.
W2149726064 title "Stent thrombosis and platelet reactivity" @default.
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W2149726064 doi "https://doi.org/10.1016/j.crvasa.2013.03.005" @default.
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